EMDR for symptoms of depression, stress and burnout in health care workers exposed to COVID-19 (HARD): A study protocol for a trial within a cohort study

Abstract

Background: Stressful events during a pandemic are a major cause of serious health problems, such as burnout, depression and posttraumatic stress disorder (PTSD) among health care workers (HCWs). During three years, HCWs, on the frontline to fight the COVID-19 pandemic, have been at an increased risk of high levels of stress, anxiety, depression, burnout and PTSD. Regarding potential psychological interventions, Eye Movement Desensitization & Reprocessing (EMDR) is a structured, strongly recommended therapy based on its well-known efficacy in reducing PTSD symptoms and anxiety. Objectives: This study, designed as a trial within a cohort (TwiC), aims to 1) estimate the prevalence of depression, burnout and PTSD in a sample of HCWs after experiencing the COVID-19 emergency (cohort part) and 2) assess the efficacy and acceptability of ‘EMDR + usual care’ for HCWs from the cohort who report significant psychological symptoms (trial part). Methods: The study, designed as a TwiC, consists of a prospective cohort study ( n = 3000) with an embedded, pragmatic, randomized open-label superiority trial with two groups ( n = 900). Participants included in the trial part are HCWs recruited for the cohort with significant symptoms on at least one psychological dimension (depression, burnout, PTSD) at baseline, 3 months or 6 months, determined by using the Patient Health Questionnaire (PHQ-9), Professional Quality of Life (ProQOL) scale, and PTSD Checklist for the DSM-5 (PCL-5). The intervention consists of 12 separate EMDR sessions with a certified therapist. The control group receives usual care. The trial has three primary outcomes: changes in depression, burnout and PTSD scores from randomization to 6 months. All participants are followed up for 12 months. Conclusions: This study provides empirical evidence about the impact of the COVID-19 pandemic and the mental health burden it places on HCWs and assesses the effectiveness of EMDR as a psychological intervention. Trial registration NCT04570202

On the path to recovery: traumatic stress research during the COVID-19 pandemic 2021–2023

“…With the wide availability and reduced time and other costs (e.g., transportation) of telehealth, this modality may be preferred to on-site services (Richardson et al, 2022 ). To reduce distress in healthcare workers during the COVID-19 pandemic we need to examine what could be effective interventions under these specific circumstances (Caille et al, 2023 ). Should long-term mindfulness practices be stimulated to maintain mental health and prevent burnout under COVID-19 stress (Hong et al, 2023 )?…”

“… Interventions for Pandemic-Affected Workers and Populations 46. Caille et al ( 2023 ). EMDR for symptoms of depression, stress and burnout in health care workers exposed to COVID-19 (HARD): A study protocol for a trial within a cohort study This protocol describes a ‘trial within a cohort’ (TwiC) design consisting of a cohort study with an embedded pragmatic randomized trial testing the effectiveness of EMDR in reducing depression, burnout and PTSD in health care workers exposed to COVID-19.…”

The integrative process promoted by EMDR in dissociative disorders: neurobiological mechanisms, psychometric tools, and intervention efficacy on the psychological impact of the COVID-19 pandemic

“…Notably, 38 patients at the earliest stage of distress to manage the ongoing trauma associated with quarantine or COVID-19 disease received a seven-session EMDR therapy that was able to reduce anxiety by 30% and traumatic and depressive symptoms by 55% (Perri et al, 2021 ). Regarding healthcare workers, a 12-session EMDR therapy proved to be effective at reducing symptoms of depression, burnout, and PTSD, with respect to the control group (Caille et al, 2023 ). In a sample of 43 healthcare workers from the Nephrology and Dialysis Service, who spontaneously decided to take part in a brief, three-session EMDR treatment, PTSD symptoms showed a significant clinical improvement (Belvedere et al, 2023 ).…”